Woelfle K D, Loeprecht H, Weber H, Zinkl K
Department of Vascular and Thoracic Surgery, Zentralklinikum Augsburg, W. Germany.
Eur J Vasc Surg. 1988 Aug;2(4):257-62. doi: 10.1016/s0950-821x(88)80035-5.
Intraoperative vascular endoscopy was used in 20 femorocrural in situ saphenous vein bypass procedures in order to control valvular incompetence, to localize side branches and to assess the integrity of the distal anastomosis. We used an Olympus Fiberscope (PF-27L) with a diameter of 2.7 mm and a working length of 80 cm, which had fixed illuminating and viewing fibers and a steerable tip, Valvulotomy was performed according to the technique described by R. Leather using a valve-cutter. In 8 out of 20 patients, partly retained valve leaflets were found by intraluminal inspection and could be immediately corrected. The integrity of the distal anastomosis was verified angioscopically in 14 patients. In addition, venous side branches, which had to be ligated, were easily identified under direct vision and localized by transillumination of the endoscopic light through the skin. Vascular endoscopy seems to be a practicable and time saving method to control in situ vein bypass procedures. The steps of the procedure and early results after 20 bypasses for limb salvage are presented.
在20例股腘原位大隐静脉旁路手术中采用术中血管内镜，以控制瓣膜功能不全、定位侧支并评估远端吻合口的完整性。我们使用了一台直径2.7毫米、工作长度80厘米的奥林巴斯纤维内镜（PF - 27L），其具有固定的照明和观察纤维以及可转向尖端。根据R. Leather描述的技术，使用瓣膜切割器进行瓣膜切开术。在20例患者中的8例中，通过腔内检查发现部分保留的瓣膜小叶，并可立即进行纠正。14例患者通过血管内镜检查证实了远端吻合口的完整性。此外，必须结扎的静脉侧支在直视下很容易识别，并通过内镜光透过皮肤的透照定位。血管内镜似乎是一种可行且节省时间的方法，用于控制原位静脉旁路手术。本文介绍了该手术步骤以及20例用于肢体挽救的旁路手术后的早期结果。
